Artificial Intelligence in Dentistry and dental practice, ethical implications and future predictions.

Dental professionals see many patients a day and provide a variety of different procedures requiring them to use specific body movements and positions for long periods of time. This increases the prevalence of musculoskeletal disorders among dentists and if chronic and severe, can in some instances reduce the longevity of a clinician’s dental career. Many dental professionals accept that in the realm of health and wellbeing, prevention is always better than a cure. In this article, concepts of dental ergonomics and stretching will be discussed to allow dental professionals to practise with greater ergonomic safety and prevent work-related musculoskeletal disorders from occurring and ensure longevity in a dental career.

Wisdom teeth or third molars have the greatest variability in development, eruption times, tooth morphology and position. They are commonly associated with impaction due to the lack of space for eruption. Impacted wisdom teeth sometimes require complex extractions whereas others require simple extractions. Knowing how and when to refer to an oral maxillofacial specialist is a great skill. Some cases provide an opportunity to improve confidence in carrying out minor oral surgery but others need to be treated by a specialist. Most private dental clinics are now equipping themselves with the latest technology which is an exciting learning opportunity. With modern day technology/software referrals are simple and streamlined so that urgent cases can be dealt with promptly. Connecting with specialists in the community, knowing the referral process i.e. how to refer, when to refer and when not to, improves clinical practice.

Dental erosion or tooth-wear is a challenge for oral health practitioners as it is a multifactorial condition affecting both children and adults. It is increasing in incidence and prevalence due to modern-day diets and habits. The majority are aware that a high sugar diet causes dental issues however, most are unaware of the role of acidic foods and beverages.

Understanding dietary factors and the role they play in oral health holds the key to preventive dentistry. So what does that look like for you? What dietary factors or what I call ‘Hidden Sugars’ are there, lurking in the unknown waiting to cause some havoc? I’m sure we can find some, so let’s take a look.

Discover the inspiring journey of William ‘CJ’ Carlson Jones and his pathway to leadership.

Dental caries is one of the most prevalent chronic non-communicable diseases in the world, and the older population is at a disproportionately high risk. In Australia, the Australian Dental Association Oral Health Tracker estimates that only 10.7% of adults over 15 years have never experienced tooth decay.

How do I get my fillings to stick to teeth? Here are 5 tips on 4th generation adhesive bonding to get the best out of your fillings

Bad breath can commonly be attributed to dental and oral hygiene issues. As such, it is an issue that dental professionals should be well-equipped in openly discussing should patients enquire about it. In this short article, Dr Sam Koh explores and summarises the most common causes of bad breath as well as simple ways to prevent or treat it

Oral disease processes are insidious and progressive, often remaining invisible to the layperson until the end stage. Self-diagnosis is often delayed until patients notice irreversible signs - frank cavitation as caries undermines marginal ridges and advances inexorably towards vulnerable pulps, progressive tooth mobility or gingival recession with declining periodontal health and functio laesa in the case of expanding oral cavity neoplasms that may have begun as subtle precursor lesions. If evading the watchful eye of a supervising dental practitioner, ailments of the intraoral hard and soft tissues can easily go unchecked until patients experience advanced disease, at which point it becomes increasingly invasive and expensive to manage. Dental professionals have the capacity to identify disease risk factors and to detect signs of disease at the pre-symptomatic stage, at which point it is possible to arrest and reverse disease progression by providing tailored lifestyle counselling to encourage health-promoting behaviours. This article will delve into current barriers to our transition away from the reactive modus operandi of dental healthcare towards a more medical, person-centred model of caries management to break the restorative death spiral and curb rates of edentulism in our community

The intention of this article is to highlight the importance of adapting communication when treating children. Motivating children to learn about oral disease, and change oral health habits can be challenging. There are different techniques and resources that can help oral health professionals understand childrens’ unique learning styles.

Helping patients understand hypersensitivity

During the COVID-19 outbreak, it is more important than ever for dental practitioners to educate patients on periodontal disease and oral-systemic health.

Advocates for Oral Health articles for dentists, hygienists, and other dental professionals. Colgate® Professional has these resources and more to promote better oral health.

The eruption of a child's teeth is a natural and gradual process that varies amongst individuals. Understanding the normal sequence of tooth eruption can help parents know what to expect and when to seek professional advice. Parents have various concerns about teeth eruption which is a significant aspect of development. Some concerns they may have are when teeth erupt too early or when teeth erupt late and also when teeth may erupt in an irregular pattern. There is a general guideline for teeth eruption and it is the responsibility of oral health professionals to provide parents, families and caregivers with the right information at the appropriate time. Communicating with parents and caregivers about early and late eruption of teeth is crucial for ensuring proper dental care for children, maintaining optimal oral health and avoiding complications.

COVID-19 pandemic has exacerbated plastic pollution which is a major contributor to climate change. Environmental sustainability efforts have slowed down as a result especially in the dental industry. To protect public health PPE was used to prevent cross-infection and reduce transmission rates. The pandemic has had a considerable effect on the environment. There is growing interest amongst oral health practitioners to become more environmentally friendly but there is a lack of motivation due to unclear guidelines and gaps in knowledge. The dental industry needs to address environmental sustainability issues and advocate for better policies. This requires a collaborative and interdisciplinary approach to accelerate efforts in reducing emissions and achieving carbon emissions reduction targets.

To overcome Imposter Syndrome, foster good work relationships, hone your niche, focus on your strengths, delegate tasks and champion autonomy.

You’ve finally graduated and millions of thoughts buzz through your head as you refine your clinical skills treating patients. It’s a steep learning curve and you begin to notice aspects of your patient’s health that extend beyond the oral cavity, yet still impact upon their dental health. Whilst we all do a wonderful job of managing our patient’s oral health, it’s a time to reflect on the importance of establishing strong interdisciplinary relationships with other professionals and health providers.

As a clinician-scientist, you could solve a clinical challenge, improve how we practise Dentistry and optimise patient care.

As dental practitioners we are motivated to help people. Our good intentions are inspired by our belief in right and wrong, but can our belief system lead us astray? Can ‘good intentions’ lead to unsafe practices in dentistry?

Recent global events causing uncertainty of the future, and change from our normal ways of living prior to COVID-19, has led to an increase in patients presenting with worn, chipped or cracked teeth. Increased stress levels in life lead to increased or new incidences of grinding and clenching habits during the night or day which may not have previously existed, leading to significant shear forces being exerted on teeth and fracturing or wearing the enamel. Whilst the foundations of prevention in dental health have previously focussed more on the oral hygiene habits of regular brushing and flossing to maintain healthy gums and teeth, protecting the biting surfaces of the teeth from grinding and clenching is now an additional, critical, preventative focus. One great way to help protect your patient’s teeth in the long term is the use of an occlusal guard.

The bridge between oral and systemic health exists and becomes more concrete as data continue to emerge in support of this relationship.

Find articles on a wide variety of oral care and overall health issues impacting patients. These resources may be useful in helping your patients achieve better oral hygiene.

Read articles and view videos on topics pertaining to tooth sensitivity for dental professionals. Use to inform your patients when new information or practices are found.

Conveying information to obtain informed consent can be complicated when trying to consider all relevant factors. Read on for a concise summary of the key components to consider.

Read articles on topics related to caries, symptoms, and treatment allowing dental professionals to stay up to date with current events in oral care.

Recent evidence suggests that periodontal interventions aimed at controlling local inflammation may reduce the risk of systemic diseases such as diabetes mellitus (DM) and cardiovascular disease (CVD), which have been associated with periodontal diseases. According to Professor David Paquette, Dean for Education at Stony Brook University School of Dental Medicine, USA, there is ample study and case-based evidence linking both CVD and DM with periodontal inflammation.

Dental Caries – Target, Intercept and Take Control, Dr Kareen Mekertichian

Preventive products for older adults- using the evidence and getting it right

Practical Oral Care: A video for residential care staff

Part of our role as dental professionals is to educate our patients on oral hygiene and their oral health. Besides discussing brushing and flossing habits, I personally find myself speaking to my patients regularly about preventing dental decay and acid wear by modifying their dietary habits.

LGBTQIA+ patients are often subject to a great deal of societal stigmatisation and discrimination. Read on to learn how to create a safe and inclusive space for LGBTQIA+ patients in the dental clinic.

It is essential that patients have a clear understanding of the oral hygiene practices required to keep their prostheses, and restorations, in good condition. Good care may limit the need for replacement in a shorter-than-anticipated time frame.

Patients with special needs are classified as all individuals who present physical, sensory, mental, developmental, medical or cognitive limitations, and who require special consideration when receiving dental treatment. The scope is broad considering the multitude of cases that may fit under these categories. These conditions necessitate special dental treatment plans, medical management and use of specialised programs or services to prevent or treat oral health problems.

Graduating from dental school and becoming a fully registered dental professional can be an exciting chapter of life and marks the beginning of our professional careers. However dental school only provides the foundational skills for us to be safe clinicians. Our journey of learning truly begins the first day on the job as qualified dental professionals.

Comprehensive treatment planning can be challenging when considering complex patient needs. The phases of care framework can be used by dental practitioners to formulate a methodical and patient-centered treatment plan.

Graduated, found a job and have started seeing patients. The daunting transition from student to dentist. For those of you who are in the midst of this transition period, I am right there with you! Scary and exciting, all at the same time.

Having recently begun work as a graduate dentist, my first few months were defined by an incredibly steep learning curve. While I readily embrace the clinical feedback imparted by my mentors, being more assertive is advice that I have always struggled to take.

We know that oral health is associated with diet in many ways, and we can track this back to ancient times. Dental palaeopathology or the study of ancient teeth, reinforces for us, as oral health professionals, the importance of addressing dietary habits and behaviors with our patients.

As dental professionals, there are numerous ways that we can practice a high level of social responsibility and advocate for better community oral health outcomes. Read on to learn of the strategic areas to focus upon when looking to improve one’s social responsibility.

Social determinants of health can greatly impact individual health. For rural and remote Australians, geographic location can impact both oral health status and the ability to access oral health care. Working in such locations can be difficult, but a satisfying career choice.

“Fake news” seems to be today’s “real news”. Gone are the days where people relied solely on the morning newspaper and the 6 o’clock news for their information, or their trusted health professional for up-to-date oral health advice. We now have so-called experts and sources anywhere and everywhere, which, through all the various media platforms out there such as social media, have the ability to reach our patients in ways they were never able to previously. With the plethora of sources, this can no-doubt cause some confusion to our patients. There is a probability that many of these sources are not professionally educated, which may then lead to potential health ramifications for our patients. We as the true oral health professionals need to therefore be firstly aware that this is happening, and secondly, understand the basis of these fads so we know how to tackle them head-on. As professionals, we need to differentiate ourselves from these other sources and be able to provide our patients with a much clearer understanding of what is fact or fiction.

As dental professionals one of the most common demographic of patients we manage and treat are those with dental anxiety. Especially early in the career, it can be quite challenging managing their anxiety to allow you to safely and effectively provide the necessary dental treatment and care they require. Within this group of patients, a subset suffer from poor oral health, only visiting the dentist when there is a severe toothache.

Each year that ticks around I pause at the question asked, when renewing my AHPRA registration, ‘How many more years are you likely to practice within the dental profession?’. In my first few years I would enter a large, overwhelming number that would make my head spin; am I really going to be drilling and filling for that many more years?! With fear of monotony, burnout and fatigue more evident in society, many of us may question, ‘what else can I do with my degree?’. Clinical dentistry does not have to be the sole role for dental professionals, many pathways exist beyond the dental chair with many others yet to be discovered.

COVID-19 has devastated global communities and drastically changed the operation of almost every domain of society, culminating in a radical transformation of everyday life as we know it. As alarming ICU footage and eye-opening exponential curves began to take the world by storm, notions of “quarantine” and “self-isolation” began to enter our vernacular and routines, followed by a subsequent wave of politicians concluding that, after careful consideration of letters from distressed local children, the Tooth Fairy and Easter Bunny (two dangerous potential superspreaders) would be exempt from travel and social-distancing restrictions. In the face of extreme change and uncertainty, dentists’ initial panic surrounding the threat of rapidly diminishing and exorbitantly expensive mask and sanitiser supplies was swiftly surpassed by grave concerns for public safety, with the subsequent closure of many clinics being accompanied by donations of remaining PPE to our medical colleagues on the frontline.

Taking the time to understand and work through the unique barriers to performing at-home oral hygiene and accessing professional care is a core responsibility of our profession that can elicit satisfying changes in our patients’ behaviour and oral health.

I thought that I no longer enjoyed dentistry. Turns out, I just no longer enjoyed where I was practicing. I made the move to work outside the clinical environment with a six-month break before working one day per week clinically. Making these changes helped to reignite my enjoyment of working in the dental profession. However, it was not the dentistry that was causing me grief. As part of my Master’s in Public Health I undertook a public health management subject where I learnt about leadership vs management, how personality affects leadership style through the Myers Briggs personality test but importantly culture and it was there I clicked that that was what was affecting my enjoyment in work

In the whirlwind of parenting, the pursuit to simply meet bub’s basic needs can feel overwhelming at times. It’s often not until parents notice changes in their little one’s behaviour that they realise that perhaps one of the more essential aspects of their care has been overlooked and, by that point, it’s often too late.

We have all encountered patients whose poor health literacy has been to the detriment of their oral health-related quality of life, with their caries experience, periodontal condition, and attitudes towards visiting the dentist being influenced by their lack of access to adequate health education in their formative years. Thus, as outlined in the Australian Dental Association’s 2017 Australian Dental Health Plan, there is a significant need for members of our profession to undertake educational campaigns to promote positive oral health messages in the wider community. Schools provide an effective platform for the delivery of such messages early in life, which may foster their life-long adoption of beneficial attitudes and lifestyle habits that will allow them to maintain optimal oral and general health.

Patient communication is constantly underrated and undervalued. However, the world we live in is constantly-changing, with the advent of new information sources such as alternative websites and social media. We need to therefore be at the forefront of information and stay on top of everything, steering our patients on the right path towards better dental health. It is seldom talked about during dental school, yet our dental communication is the vital bridge between our comprehensive understanding of our patient’s dental health and their acceptance, acknowledgement and willingness to address the situation.

As dental professionals, we are in a prime position to discuss nutrition with our patients and of course, the main topic that comes to mind is sugar! Nutritional information, particularly regarding sugar consumption, is available en masse to the public, particularly through social media. However, these sources, who often possess no formal qualifications, usually do not consider sugar and its effects on oral health when providing advice, therefore recipes online touted as ‘added sugar free’ or ‘refined sugar free’ may still have high cariogenicity. Regarding sugar, the best advice for Australians to follow is the recommendations made by the World Health Organization (WHO). WHO’s 2015 Guideline on sugars intake for adults and children1 made a ‘strong’ recommendation that intake of free sugars should not exceed 10% of total energy intake (approximately 48 grams or 12 teaspoons) for the prevention of unhealthy weight gain or dental caries. WHO made an additional ‘conditional’ recommendation that intake of free sugars should not exceed 5% of total energy intake, providing additional health benefits, in particular, in relation to dental caries. In 2011-12 the Australian Bureau of Statistics (ABS) reported 14-18 year old males consumed an average of 92 grams of free sugars per day (22 teaspoons) while their female counterparts consumed an average 70 grams (17 teaspoons)2. These values well and truly sit above WHO’s recommendations, which reference all mono and disaccharides added to foods, as well as sugars in syrup, honey, fruit juice and fruit juice concentrate. WHO’s recommendations do not include the sugars naturally present in milk, milk products or whole fruits, vegetables, and grains. Food Safety Australia and New Zealand (FSANZ) report consumers have trouble classifying sugars as ‘natural’ or ‘added’ and perceive that ‘natural’ sugars are healthier.2 This belief can be potentially damaging when ‘natural sugars only’ is a commonly used advertising tactic, yet the food item may contain well over 15 grams of sugar per 100 grams, above which, sugar content is considered high. Without appropriate knowledge, individuals will meet their recommended daily intake much more quickly and potentially increase their risk of tooth decay and/or weight gain. But who can blame people for their confusion, really? Sucrose, refined cane sugar, agave syrup, brown sugar, high-fructose corn syrup, lactose, glucose… Free, added, natural, total… There are over fifty terms that can be used to describe sugar as an ingredient in foods and drinks. Nutrition, in particular regarding sugar consumption, should be a staple discussion between oral health professionals and patients. Look to provide feedback on what patients already know, tailor advice as necessary and help to set goals. But do not forget to account for social determinants including individual health literacy when discussing such topics. Consider adding to the traditional advice provided by dentists to reduce intake frequency and ensure that patients do not instead consume the same amount of sugar in a single daily sitting rather than through frequent snacking. Discussions should encourage not only to reduce the frequency of intake but also a total reduction in free sugar consumption; as health professionals, we must consider whole body health, not just the mouth. Along with WHO’s recommendations, suggestions for patients and/or their parents/carers could include the following: Consume 2 serves of fruit and 5 serves of vegetables daily, as per the Australian Dietary Guidelines.3 Fresh fruit makes for a great snack or dessert option, or for something less sweet, consider cheese or nuts, while vegetables make a great snack for any time of day. When reviewing the Nutrition Information Panel (NIP), look for foods with less than 15 grams of sugar per 100 grams, however, ideally, try for those with less than 5 grams. If sugar is included in the top three ingredients on the NIP or the listed ingredients includes multiple references to sugar, consider looking for a healthier alternative. When replacing free sugars in the diet, do so with starch-rich staple carbohydrates such as bread, cereals, rice, pasta (preferably wholegrain) and fresh fruits and vegetables.4 Carry a reusable water bottle to encourage the consumption of tap water rather than purchasing sugar-sweetened beverages. FSANZ reports that sugar information is one of the first elements that Australian consumers look for on the NIP.2 Therefore as health professionals we should continue to provide brief interventions and discuss this important topic with patients to empower them to enact this behaviour, however, look to also support programs and policies developed for population-scale changes. 1 Guideline: Sugars intake for adults and children. Geneva: World Health Organization; 2015. 2 Policy context relating to sugars in Australia and New Zealand. Food Standards Australia and New Zealand; 2017. 3 Eat for health Australian Dietary Guidelines. NHMRC; 2013. 4 Moynihan P, Makino Y, Petersen PE, Ogawa H. Implications of WHO Guidelines on Sugars for dental health professionals. Community Dentistry and Oral Epidemiology. 2018;46:1-7. About the Author: Dr Mikaela Chinotti, BDS, MPH, has been practising as a general dentist for 7 years. She has previously worked in rural and regional government, private and health fund owned practices in North Queensland. Her passion lies in minimal intervention dentistry, health promotion and health education. Now in Sydney, Mikaela works as the Australian Dental Association (ADA) Oral Health Promoter as well as part time as a general dentist.